Emergency Preparedness

Appendix O.7 HICS 221 DEMOBILIZATION CHECK-OUT

1. Incident Name

2. Operational Period (# ) DATE: FROM: _______________________ TO: _________________________

TIME: FROM: _______________________ TO: _________________________

3. Section Demobilization Checks Use as positions and resources are demobilized. The position and the resources may only be released when the checked boxes below are signed off, all equipment is serviced and returned, and all paperwork turned in to the Documentation Unit Leader. Respective Section Chiefs must initial their sections showing approval for demobilization. COMMAND STAFF INCIDENT COMMANDER REMARKS INITIALS

All units, branches, and sections have been demobilized. All paperwork has been gathered for review and development of After Action Report. Final message to staff, media, and stakeholders has been developed and disseminated. All clinical operations have returned to normal or pre-incident status. Hospital Command Center and Emergency Operations Plan are deactivated.

PUBLIC INFORMATION OFFICER

REMARKS

INITIALS

Final media briefing is developed, approved, and disseminated. Final staff and patient briefings are developed, approved, and disseminated. Social media is updated with current status.

LIAISON OFFICER

REMARKS

INITIALS

All stakeholders and external partners are notified of Hospital Command Center deactivation/return to normal operations.

SAFETY OFFICER

REMARKS

INITIALS

Final safety review of facility is completed and documented. All potential hazards have been addressed and resolved. All sites/hazards have been safely mitigated/repaired and are ready to be used. Appropriate regulatory agencies are notified. All safety specific paperwork is completed and submitted.

MEDICAL / TECHNICAL SPECIALIST (TITLE) _______________________________

REMARKS

INITIALS

Position-specific roles and responsibilities have been deactivated. Response-specific paperwork is completed and submitted to Documentation Unit Leader. MEDICAL / TECHNICAL SPECIALIST (TITLE) _______________________________ Position-specific roles and responsibilities have been deactivated. Response-specific paperwork is completed and submitted to Documentation Unit Leader. MEDICAL / TECHNICAL SPECIALIST (TITLE) _______________________________

REMARKS

INITIALS

REMARKS

INITIALS

Position-specific roles and responsibilities have been deactivated. Response-specific paperwork is completed and submitted to Documentation Unit Leader.

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